Pharmacotherapy Update: Vinorelbine in the Treatment of non-small-cell Lung cancer

Abstract

Non-small cell lung cancer (NSCLC) is the most deadly cancer in the world. Vinorelbine is an active vinca-alkaloid with a broad spectrum of anti-tumour activity. In particular, it has high activity in NSCLC, where a synergy with cisplatin has been demonstrated. Recently, oral vinorelbine has shown a similar activity and efficacy as compared to the intravenous formulation, giving to the patient an easier way of administration and increasing his comfort. Although surgery remains the best chance of cure for patients with resectable NSCLC, it is now accepted that postoperative cisplatin-based adjuvant chemotherapy significantly improves survival in patients with NSCLC. The combination of cisplatin and vinorelbine is the most active among all the adopted schedules. Patients presenting with locally advanced disease at diagnosis benefit from concomitant chemotherapy with cisplatin-vinorelbine regimen in combination with thoracic radiotherapy. Platinum-based combinations have become the standard of care for treating NSCLC. Vinorelbine–cisplatin combination is one of the proposed doublets for treating advanced, metastatic, NSCLC. Because of its favorable toxicity profile, vinorelbine has become a major compound as a treatment for elderly patients with advanced NSCLC.

Modifications on the Basic Skeletons of Vinblastine and Vincristine

“…This derivative is a potent antitumor agent in the treatment of non-small cell lung cancer [18]. In addition vinorelbine (33) and anhydrovinblastine (32) were hybridized through the 17-hydroxy group of the vindoline part with colchicine, podophyllotoxine and baccatine III to investigate the effect of the new molecules on the polymerisation of tubuline [19].…”